Active NPI
Roy Hall
- Adult Companion
- Lithonia, GA
National Provider Identifier
1992934657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 859 Shadow Lake Dr
Ste 100
Lithonia, GA 30058-3226 - Phone
- (770) 498-8644
- NPI assigned
- Jul 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
859 Shadow Lake Dr
Ste 100
Lithonia, GA 30058-3226
Mailing address
859 Saddle Lake Dr
859 Saddle Lake Dr
Lithonia, GA 30058-3226
Phone (770) 498-8644
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246492800000",
"number": "1992934657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "859 SADDLE LAKE DR",
"address_2": "859 SADDLE LAKE DR",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300583226",
"telephone_number": "770-498-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 SHADOW LAKE DR",
"address_2": "STE 100",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300583226",
"telephone_number": "770-498-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "ROY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-02",
"last_updated": "2009-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lithonia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.